Deborah H. A. Van Horn, Ph. D., LLC - Motivational Interviewing Training

Course Materials and Resources for Intro to MI 8-Week Teleclass for MUSC: September - November, 2006

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Course Materials / Recommended Books / Web Sites / Training Videos / Session-Specific Resources / Transcripts

"Teaching Client" Roleplay Guidelines

Session 1 / Session 2 / Session 3 / Session 4 / Session 5 / Session 6 / Session 7 / Session 8 /

 

Course Materials

I encourage you to keep the handout on hand during the calls to help focus your attention on the main points of the discussion. Click on the link below to view the handout, and then choose "save a copy" to save to your computer. Or, right click on the link, select "save target as," and choose where on your computer you want the file to go. (Mac users, you are on your own)

Course handout (303k PDF) - includes calling instructions, session handouts

Transcript of audio case example from first session (30k PDF)

If you can't open the files, click here to download Adobe Reader for free.

 

Recommended Books

Motivational Interviewing, Second Edition: Preparing People for Change (MI2) by William R. Miller and Stephen Rollnick

  • Includes extensive (but highly readable) discussion of theoretical underpinnings, empirical evidence
  • Some detailed examples of strategies and techniques with an emphasis on general principles
  • Specialty settings, populations, topics featured in extensive edited section
    Read my detailed review
    See more information at Amazon.com

A briefer, more practice-oriented text focusing on application in medical settings (may supplement or substitute for MI2):

Health Behavior Change: A Guide for Practitioners (HBC) by Stephen Rollnick, Pip Mason, and Chris Butler

  • Designed for application in medical settings; does not assume a background in general counseling skills
  • Presents a framework for very brief treatment encounters
  • Strategies are presented in terms of principles, examples, and counterexamples with an emphasis on practicality.
    Read my detailed review
    See more information at Amazon.com

Web Sites

Steve Rollnick's practice-oriented online discussion board

The Motivational Interviewing Page

Ordering Information for Training Videos (Optional)

Miller/Rollnick/Moyers professional training video series, 1998 (aka "New Mexico" video series)

Additional training videos (including French and Spanish)

"Teaching Client" Roleplay Guidelines

If you have the opportunity to work with a role-play partner, then you can develop a "teaching client/patient" role to help maximize your learning. When in the role of the teaching client, your job is to help each other learn MI. The teaching client is NOT the client from Hell! The teaching client should also NOT be based solely on a single real client or patient. Develop a role that is familiar from your work and that you can role-play convincingly. Consider: demographics (age, gender, race, marital status, household composition); socioeconomic background; the clinician's and client's perspective on what is the presenting problem (these may disagree); the client's goals and values; the pros and cons of the problem behavior from the client's perspective; the pros and cons of the desired behavior from the client's perspective. Keep the roleplays short and focused on one specific skill at a time. Allow the person in the clinician role to set (and change!) the level of readiness or resistance displayed by the teaching client. Audiotape the roleplays for review.

Session-Specific Resources

Session 1

MI2 Chapters 1-4, 11 (annotated case example), 16-17

HBC Chapters 1-2 (relevant to sessions 1-3)

Findings From Clinical Trials - Updated December 2004 (online slide presentation; or, download the Powerpoint file)

A Meta-Analysis of Motivational Interviewing Outcome Trials - November 2004 (online slide presentation; or, download the Powerpoint file)

Toward a Theory of Motivational Interviewing - November 2004 (online slide presentation; or, download the Powerpoint file)

New Mexico video tape A (also good for insomnia); tape B part 2 (extended initial interview with a substance-abusing patient)

Audio Case Example (MP3 format) - we listened to parts 1 and 2 in the telephone session. In Part 3 the client begins to consider treatment options. Click on the link to listen using your browser's media player. Or, right click on the link, select "save target as," and choose where on your computer you want the file to go. (Mac users, you are on your own)

"Rounder" Part 1 (4.88 MB, 5:19 minutes)

"Rounder" Part 2 (5.05 MB, 5:31 minutes)

"Rounder" Part 3 (4.77 MB, 5:12 minutes)

Session 2

MI may be conceptualized as a particular form of the "guiding" style of communication with patients - see Steve Rollnick and colleagues' recent British Journal of Medicine article for more about incorporating MI into daily practice without over-reliance on structured interventions.

For more about motivation and the stages-of-change approach:

Overview of the Transtheoretical (Stages-of-Change) Model from the URI Cancer Prevention Research Center

MI2 Chapter 15

Changing for Good by James O. Prochaska, John Norcross, Carlo DiClemente
Broadly applicable self-help book that models a patient-friendly way to present stage-matched interventions.
Read my review
See more information at Amazon.com

Addiction and Change: How Addictions Develop and Addicted People Recover by Carlo C. DiClemente
Transtheoretical model co-developer DiClemente reviews and extends the influential approach to cover the process of acquiring as well as changing addictive behaviors.
Read my review
See more information at Amazon.com

Books geared toward substance abuse treatment professionals (links lead to my detailed reviews):
Group Treatment for Substance Abuse: A Stages-of-Change Therapy Manual
Substance Abuse Treatment and the Stages of Change
Motivational Interviewing and the Stages of Change

 

Session 3

MI2 Chapters 6-7

Evidence for a relationship between therapist clinical skills and client involvement in MI:
Moyers, T. B., Miller, W. R., & Hendrickson, S. M. L. (2005). How does Motivational Interviewing work? Therapist interpersonal skill predicts client involvement within Motivational Interviewing sessions. Journal of Consulting and Clinical Psychology, 73, 590-598.

Suggested roleplay prompts for practicing OARS with your roleplay buddy - audiotape and review together. Where could you have used open instead of closed questions? Where could you have used even more reflective listening instead of questioning? Keep roleplays short and focused, and respect the Talker's desire to end the conversation whenever he/she is ready.

  • What have you read lately that you would recommend?
  • Who in your family are you most like?
  • Tell me about a memorable trip you took. What made it memorable?
  • What is your dream job?
  • What do you like about yourself?
  • What is the best advice you ever received?

Session 4

MI2 Chapter 5-7

HBC Chapter 4

New Mexico video tape B (parts 1 and 2)

Literature review regarding "change talk" - several articles in recent issues of the MINT Bulletin. Look for the updated "consensus statement on change talk" in the July 2006 issue. Also, look for "what the research says" articles by Grant Corbett in October 2004, May 2005, September 2005 issues.

All of the substance abuse treatment manuals listed on my resources page include exercises for eliciting change talk.

Audio clips (MP3 format) demonstrating use of specific techniques to elicit change talk: Click on the link to listen using your browser's media player. Or, right click on the link, select "save target as," and choose where on your computer you want the file to go. (Mac users, you are on your own)

BIG FILE! The good things and the not-so-good things about drinking - 8.5 MB, 6:11 minutes.

The good things and the not-so-good things about smoking - 6.86MB, 5 minutes. From the Health Behavior Change video (video companion to HBC book - no longer available). The start of this one is cut off - the counselor is asking the client what keeps her readiness to quit smoking at a 2 or 3 on a scale of 10.

Exploring values, fruits and vegetables - 4.12MB, 3 minutes. Demonstration of an MI-based peer counseling program developed by the National Cancer Institute for African-American churches. From the Body and Soul peer counselor training DVD.

Session 5

MI2 Chapter 8

HBC Chapter 5

New Mexico video tape C

Audio clips (MP3 format) demonstrating use of reflective responses to resistance. We listened to these examples during the call. Click on the link to listen using your browser's media player. Or, right click on the link, select "save target as," and choose where on your computer you want the file to go. (Mac users, you are on your own) Each clip is less than one minute long.

Simple reflection (641k)

Amplified reflection (668k)

Double-sided reflection (693k)

Session 6

MI2 Chapter 9-10

HBC Chapter 4

New Mexico video tape F

Session 7

HBC Chapter 5

Motivational Enhancement Therapy serves as a model for a feedback-based intervention in the addictions. See my resources page for more information about some of the variations.

Reid Hester's online Drinker's Check-up provides feedback regarding alcohol use. Results of a 12-month trial.

Alcoholscreening.org provides similar feedback - but in a less MI-consistent manner - for free.

Audio clips (MP3 format): Click on the link to listen using your browser's media player. Or, right click on the link, select "save target as," and choose where on your computer you want the file to go. (Mac users, you are on your own)

Example of elicit-provide-elicit to provide information to increase importance of change (4.43 MB, 3.13 minutes).

Example of elicit-provide-elicit to provide information to increase confidence for change (5.17 MB, 3:46 minutes)

Some excerpts from a feedback-based intervention. First (3.31 MB MP3, 2:24 minutes), a brief example of giving personal feedback regarding drinking. Next (5.97 MB MP3, 4:20 minutes), a summary of feedback given over a lengthy session, and example of eliciting change talk and managing resistance (in this case, demoralization more than argumentation).

Session 8

See the treatment manuals on my resources page for several examples of how MI may be structured for counseling practice.

Some examples of application of MI in a group setting:

Group Treatment for Substance Abuse: A Stages-of-Change Therapy Manual

Motivational Groups for Community Substance Abuse Programs

Van Horn, D. H.A., & Bux, D.A. (2001). A pilot test of motivational interviewing groups for dually diagnosed inpatients. Journal of Substance Abuse Treatment, 20, 191-195.
Abstract
Group Leader Materials

Audio clips (MP3 format): Click on the link to listen using your browser's media player. Or, right click on the link, select "save target as," and choose where on your computer you want the file to go. (Mac users, you are on your own)

Example of importance/confidence rulers with a client with moderate importance and low confidence (6.09 MB MP3; 4:26 minutes)

BIG FILE! Example of Behavior Change Counseling (agenda-based intervention for medical settings) (12 MB, 8:44 minutes)

 

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Updated August 23, 2006